crossing96/oncoscreening huggingface dataset:
Adverse In-hospital Outcomes According to Pelvic Lymph Node Dissection at Partial Cystectomy.	OBJECTIVE: This study was designed to test the association between adverse in-hospital outcomes and pelvic lymph node dissection (PLND) at partial cystectomy (PC) for nonmetastatic bladder cancer (BCa). METHODS: We identified patients treated with PC for BCa (National Inpatient Sample 2012-2019). First, estimated annual percentage changes (EAPC) tested temporal trends of PLND at PC. Second, descriptive analyses, propensity score matching (PSM, ratio 1:2) and multivariable logistic regression models (LRMs) were used. RESULTS: Of 1,289 BCa patients treated with PC, 201 (16.0%) underwent PLND. The rates of PLND at PC decreased from 24.8 to 5.4% over the study span (EAPC - 11.3%; p = 0.01). Pelvic lymph node dissection patients were younger (67 vs. 71 years old; p < 0.001), exhibited a lower number of comorbidities (Charlson Comorbidity Index [CCI] 0: 41% vs. 38%; p = 0.006), and were more frequently admitted to teaching (83% vs. 76%; p = 0.03) and large bedsize (69% vs. 57%; p = 0.004) hospitals. After PSM, 201 of 201 (100%) PLND vs. 402 of 1,088 (36.9%) no-PLND at PC patients were included in further analyses. Pelvic lymph node dissection at PC patients only exhibited significantly higher rate of intraoperative complications (9% vs. 3.7%; p = 0.008), but no statistically significant differences in 13 of 14 other categories were recorded (all p values > 0.09). In multivariable LRMs, PLND independently predicted 2.6-fold higher rate of intraoperative complications (p = 0.01). CONCLUSIONS: The rate of PLND drastically decreased over time. PLND vs. no-PLND at PC only resulted in a moderate increase in intraoperative complications without differences in 13 other adverse in-hospital outcomes, which included complications, in-hospital mortality, length of stay, and total hospital charges.	bladder
Implementation challenges of single-instillation intravesical chemotherapy following transurethral resection of bladder tumor.	INTRODUCTION: Despite strong evidence supporting its effectiveness, single, immediate instillation of intravesical chemotherapy (SI-IVC) following transurethral resection of bladder tumor (TURBT) remains vastly underutilized in managing low- and intermediate-risk non - non-muscle-invasive bladder cancer (NMIBC). This review addresses the gap between evidence and practice in adopting this cost-effective, recurrence-reducing intervention and offers potential solutions through an implementation science approach. AREAS COVERED: We examined the clinical benefits of SI-IVC based on landmark trials and meta-analyses across various agents, including mitomycin and gemcitabine. A targeted literature review was conducted using PubMed and major urology guidelines to identify studies assessing efficacy, utilization rates, and barriers to implementation. Particular focus is given to logistical and systems-based challenges limiting real-world application, including issues with drug availability, perioperative workflow, and post-resection coordination. We also discuss strategies informed by an implementation science framework, including planning and system engagement, executing interventions, and evaluating their impact within hospital systems. EXPERT OPINION: Incorporating SI-IVC into routine practice requires pragmatic, system-level changes that address logistical barriers rather than clinical hesitancy. With institutional support and streamlined protocols, SI-IVC can be more consistently delivered, however, local adaptation and fine-tuning remain essential, as healthcare systems and available personnel vary across institutions.	bladder
Risk factors for acute kidney injury following radical cystectomy: a systematic review and meta-analysis.	BACKGROUND: The factors contributing to acute kidney injury (AKI) after radical cystectomy (RC) remain uncertain. This study aimed to determine the risk factors for AKI following RC and guide clinicians in implementing effective interventions for high-risk groups. METHODS: Three English databases were searched for relevant articles published until November 2024. The odds ratio (OR), 95% confidence interval (CI), and P value were determined for each study using univariate or multivariate analysis. Random effects models were applied for high heterogeneity ( I2  ≥ 50% or P < 0.05) instead of fixed effects models. Moreover, descriptive analysis was performed when meta-analysis was unfeasible. We investigated heterogeneity by performing subgroup and sensitivity analyses. A funnel plot was used to test for publication bias when the number of included studies was >10. RESULTS: Nine studies were included in the meta-analysis. The meta-analysis revealed that older age (OR = 1.02, 95% CI = [1.00, 1.03], P = 0.008), operative route (robot versus open, OR = 2.41, 95% CI = [1.35, 4.31], P = 0.003), and nonsteroidal anti-inflammatory drug use (OR = 1.50, 95% CI = [1.01, 2.23], P = 0.05) were risk factors for postoperative AKI. Female gender (OR = 0.55, 95% CI = [0.35, 0.88], P = 0.01) was identified as a protective factor against postoperative AKI. Body mass index (OR = 1.02, 95% CI = [1.00, 1.04], P = 0.06), diabetes (OR = 1.00, 95% CI = [0.65, 1.53], P = 0.98), hypertension (OR = 1.76, 95% CI = [0.79, 3.93], P = 0.17), smoking (OR = 1.01, 95% CI = [0.74, 1.39], P = 0.94), cardiovascular disease (OR = 1.37, 95% CI = [0.70, 2.68], P = 0.35), estimated glomerular filtration rate (OR = 1.00, 95% CI = [0.98, 1.02], P = 0.89), neoadjuvant chemotherapy (OR = 1.23, 95% CI = [0.69, 2.20], P = 0.49), operation time (OR = 1.00, 95% CI = [0.99, 1.01], P = 0.87), intraoperative bleeding volume (OR = 1.00, 95% CI = [1.00, 1.00], P = 0.73), blood transfusion (OR = 1.46, 95% CI = [0.79, 2.72], P = 0.23), enhanced recovery after surgery program (OR = 1.35, 95% CI = [0.65, 2.78], P = 0.42), and urinary diversion (OR = 1.03, 95% CI = [0.45, 2.39], P = 0.94) were not associated with increased risk of AKI after RC. CONCLUSION: Obvious risk factors for AKI include one patient-related risk factor, such as older age, and two therapy-related risk factors, such as robot surgery and the use of nonsteroidal anti-inflammatory drugs. Moreover, obvious protective factors for AKI include one patient-related factor, such as the female gender. However, these findings should be approached carefully, as most of these risk factors exhibited minimal effect sizes. Nonetheless, they could aid clinicians in identifying high-risk patients for better prognosis.	bladder
A urine detection chip for the analysis of urinary cells and extracellular vesicles for bladder cancer screening.	Bladder cancer is the most prevalent malignant neoplasm of the urinary system. However, current techniques for bladder cancer diagnosis and prognosis are associated with significant patient discomfort and potential risk of urinary tract infection. To address these issues, we propose a non-invasive urine detection chip for isolating and identifying bladder cancer-related cells and extracellular vesicles. This chip enables simultaneous capture of exfoliated cells and blood cells for analysis, followed by microparticle-based filtration to remove cells and cell debris before capturing and analyzing extracellular vesicles for bladder cancer diagnosis. This method holds great potential in point-of-care screening and prognosis of bladder cancer.	bladder
Extracellular volume fraction quantification by equilibrium contrast-enhanced CT via automated segmentation predicts survival outcomes in bladder cancer: a propensity score-matched study.	BACKGROUND: Extracellular volume fraction (ECV) is the unoccupied space or volume of tissue that is not occupied by cells and can be used to assess the growth and invasive behavior of solid tumors. Our study aimed to investigate the ability of extracellular volume fraction in predicting the prognosis of BLCA patients. MATERIALS AND METHODS: A retrospective study recruited 319 BLCA patients who underwent surgery. The average CT value was recorded by creating 3D masks of the tumor and blood vessels, which was then used to calculate the preoperative ECV. A propensity score matching (PSM) was performed at a ratio of 1:1 to balance the baseline characteristics between the two groups. Correlations between ECV scores and pathological T stage (whether muscle invasion was present) were determined by using Pearson correlation coefficients. The effects of clinical or pathologic prognostic factors and ECV on recurrence-free survival (RFS), overall survival (OS) were assessed by univariate and multivariate analyses using Cox proportional risk models. RESULTS: The 319 patients were divided into two groups, ECV-lower group (n = 178) and ECV-higher group (n = 141). After PSM analysis, patients in the ECV-lower group (n = 121) and patients in the ECV-higher group (n = 141) were obtained. In multivariate analysis, ECV was the independent prognostic factor for RFS (ECV-higher: HR: 2.55, 95% Cl: 1.85 to 3.51, p < 0.01), and for OS (ECV-higher: HR: 5.46, 95% Cl, 1.89 to 15.73, p = 0.02). A positive correlation between ECV and pathologic T stage was found both before and after PSM (r = 0.225, p < 0.001; r = 0.136, p = 0.028). CONCLUSION: ECV can be used as a noninvasive biomarker to assist in the prognostic assessment of BLCA patients. Higher preoperative ECV indicates a poor prognosis for BLCA and requires aggressive treatment.	bladder
Pelvic lymph-node dissections in bladder and prostate cancer surgery and the risk of postoperative venous thromboembolism.	INTRODUCTION: To evaluate the risk of venous thromboembolic events in patients operated with radical cystectomy or radical prostatectomy and pelvic lymph-node dissection. MATERIAL AND METHODS: Patients operated with radical cystectomy for bladder cancer or with radical prostatectomy for prostate cancer from 1997 through 2016 were identified from Swedish nationwide registers. We estimated odds ratios of association between lymph-node dissection and pulmonary embolism and deep venous thrombosis (DVT) using logistic regression adjusted for the probability of having lymph-node dissection. RESULTS: In total, 6069 patients operated with radical cystectomy and 36 911 patients with radical prostatectomy were included. The risk of pulmonary embolism and DVT after radical cystectomy with lymph-node dissection was 1,89 % and 2,29 %, and without lymph-node dissection 1,99 % and 2,35 %, respectively. After radical prostatectomy and lymph-node dissection the risk for pulmonary embolism and DVT were 0,97 % and 1,36 %, and without lymph-node dissection 0,42 % and 0,49 %, respectively. Pelvic lymph-node dissection during a radical cystectomy was not associated with pulmonary embolism (OR 0,99; 95 % CI 0,65-1,51) or DVT (OR 0,99; 95 % CI 0,68-1,48), whereas lymph-node dissection during radical prostatectomy was associated with higher odds of both pulmonary embolism (OR 2,29; 95 % CI 1,67-3,09) and DVT (OR 2,95; 95 % CI 2,27-3,85). CONCLUSION: Pelvic lymph-node dissection did not increase the risk of venous thromboembolism after a cystectomy, whereas we found an increased relative risk of venous thromboembolic events associated with radical prostatectomy with lymph-node dissection.	bladder
Assessing Response Durability and Survival After Second-Line Pembrolizumab in Advanced Urothelial Carcinoma: A Multicenter Validation of a Risk Model.	OBJECTIVES: Second-line pembrolizumab improves the overall survival (OS) of patients with metastatic urothelial carcinoma (UC). We sought to develop and validate a risk model that can predict OS and response duration. METHODS: We retrospectively analyzed patients with advanced UC treated with second-line pembrolizumab at a single institution. Factors predicting time to progression (TTP) were assessed in univariate and multivariate Cox regression. Patients were divided into risk groups according to independent TTP predictors. The impact of risk group on OS was assessed. Validation utilized an independent dataset from 59 centers. Survival was estimated using the Kaplan-Meier method. RESULTS: The study comprised 565 patients (creation: 69; validation: 496). Factors predicting inferior TTP in multivariate analysis: interval from prior chemotherapy < 6 months (HR: 2.06, 95% CI: 1.16-3.66, p = 0.014), liver metastasis (HR: 2.39, 95% CI: 1.29-4.45, p = 0.009), and Eastern Cooperative Oncology Group Performance Status > 1 (HR: 4.62, 95% CI: 2.42-8.82, p < 0.001). Median OS in the creation cohort was 29, 8.3, and 3.7 months for favorable (0 risk factors), intermediate (1 risk factor), and poor-risk (≥ 2 risk factors) groups, respectively, with p < 0.001. The corresponding OS times in the validation cohort were 21.6, 11.7, and 4.9 months, respectively, with p < 0.001. Among responders, median duration of response was 38.9, 13.8, and 7.8 months for the favorable, intermediate, and poor-risk groups, respectively, with p < 0.001. CONCLUSIONS: We developed and validated a risk model that can predict response durability and OS after second-line pembrolizumab for advanced UC. Alternative treatments might be warranted for the poor-risk group.	bladder
ERRATUM FOR CYSTECTOMY IN METASTATIC BLADDER CANCER: FEASIBILITY, SAFETY AND OUTCOMES PUBLISHED IN EXP ONCOL 2024;46(4).	Cystectomy in Metastatic Bladder Cancer: Feasibility, Safety and Outcomes Hrechko B, Voylenko O, Pikul M, Vitruk U, Stakhovsky O, Kononenko O, Semko S, Koshel D, Tymoshenko A, Buyvol O, Stakhovsky E. Exp Oncol. 2024;46(4):345-350 DOI: https://doi.org/10.15407/exp-oncology.2024.04.345.	bladder
Beta-Lapachone: Effects on Proliferation, Survival, Migration, Cell Cycle, and lncRNA Modulation in Bladder Cancer Cells With Distinct TP53 Profiles.	α-Lapachone (aLAP) and β-lapachone (bLAP) are noteworthy anticancer naphthoquinones. The chemoresistance observed in bladder cancer represents a global health concern, with relation to mutations in the TP53 gene and alterations in the expression of long noncoding RNA (lncRNAs). This study evaluated the effects of aLAP and bLAP on bladder tumor cell lines with different TP53 statuses: RT4 low-grade tumor with wild-type TP53), T24 and J82 (high-grade tumor with mutation in the TP53 gene). Cytotoxicity was assessed using the MTT reduction method and cell migration by scratch assay, while clonogenic survival and cell cycle were evaluated through cell colony counting and flow cytometry, respectively. The expression of lncRNAs linked to bladder cancer and associated with tumor progression and prognosis (JHDM1D-AS1, SBF2-AS1, CDT-2132N18.2, and RP11-363E7.4) and the JHDM1D gene was evaluated through RT-qPCR. bLAP demonstrated greater cytotoxicity than aLAP. Its inhibitory effects on clonogenic survival, migration, and the cell cycle were observed in all cell lines and were related to the modulation of lncRNAs expression. A reduction in lncRNA SBF2-AS1 and JHDM1D gene expression was observed in RT4 cells, accompanied by an increase in lncRNA RP11-363E7.4. Conversely, in the cells with mutated TP53 (J82), a reduction in JHDM1D-AS1 and JHDM1D was observed. The downregulation of JHDM1D-AS1 and SBF2-AS1, along with the upregulation of RP11-363E7.4, may be associated with the observed inhibition of proliferation and cell migration following bLAP treatment. The antiproliferative effects of bLAP in bladder cancer cells are independent of TP53 statuses, yet occur through a distinct action mechanism, with variations in lncRNAs expression.	bladder
Tumor-intrinsic ENO1 inhibition promotes antitumor immune response and facilitates the efficacy of anti-PD-L1 immunotherapy in bladder cancer.	Immunotherapy has revolutionized cancer treatment, yet understanding immunotherapy resistance mechanisms remains challenging. Here, a CRISPR cas9 screening in vivo and an RNA-sequencing for clinical immunotherapy resistance BC samples identified enolase 1 (ENO1) as a potent regulator of anti-PD-L1 treatment efficacy. Investigation of clinical BC samples demonstrated a correlation between ENO1 overexpression and immune evasion in BC, evidenced by reduced CD8(+) T cell infiltration and resistance to anti-PD-L1 therapy. Increased CD8(+) T cell infiltration and function were indicative of antitumor immunity, which was elicited by ENO1 knockdown, which also suppressed carcinogenesis. Single-cell RNA sequencing demonstrated that wild-type (WT) and ENO1 knockout (KO) tumors have different immune cell compositions with the latter preferring an immunostimulatory microenvironment. Mechanistically, ENO1 regulated CD8(+) T cell function and tumor-associated macrophage (TAM) polarization via the SPP1-ITGA4/ITGB1 pathway in the TME. Importantly, genetic and pharmacological inhibition of ENO1 sensitizes tumors to anti-tumor immunity and synergizes with anti-PD-L1 therapy. The results highlight tumor-intrinsic ENO1 as a critical regulator of tumor immune evasion in BC. Targeting ENO1 enhance the efficacy of immune checkpoint blockade therapy by promoting antitumor immunity.	bladder
Ultrafast T2-weighted MR imaging of the urinary bladder using deep learning-accelerated HASTE at 3 Tesla.	OBJECTIVE: This prospective study aimed to assess the feasibility of a half-Fourier single-shot turbo spin echo sequence (HASTE) with deep learning (DL) reconstruction for ultrafast imaging of the bladder with reduced susceptibility to motion artifacts. METHODS: 50 patients underwent pelvic T2w imaging at 3 Tesla using the following MR sequences in sagittal orientation without antiperistaltic premedication: T2-TSE (time of acquisition [TA]: 2.03-4.00 min), standard HASTE (TA: 0.65-1.10 min), and DL-HASTE (TA: 0.25-0.47 min), with a slice thickness of 3 mm and a varying number of slices (25-45). Three radiologists evaluated the image quality of the three sequences quantitatively and qualitatively. RESULTS: Overall image quality of DL-HASTE (average score: 5) was superior to HASTE and T2-TSE (p < .001). DL-HASTE provided the clearest bladder wall delineation, especially in the apical part of the bladder (p < .001). SNR (36.3 ± 6.3) and CNR (50.3 ± 19.7) were the highest on DL-HASTE, followed by T2-TSE (33.1 ± 6.3 and 44.3 ± 21.0, respectively; p < .05) and HASTE (21.7 ± 5.4 and 35.8 ± 17.5, respectively; p < .01). A limitation of DL-HASTE and HASTE was the susceptibility to urine flow artifact within the bladder, which was absent or only minimal on T2-TSE. Diagnostic confidence in assessment of the bladder was highest with the combination of DL-HASTE and T2-TSE (p < .05). CONCLUSION: DL-HASTE allows for ultrafast imaging of the bladder with high image quality and is a promising addition to T2-TSE.	bladder
Developing angiogenesis-related prognostic biomarkers and therapeutic strategies in bladder cancer using deep learning and machine learning.	Bladder cancer (BLCA) is a prevalent urological malignancy that exhibits a high degree of tumor heterogeneity and morbidity. Tumor angiogenesis, a vital hallmark of cancer, greatly influences the tumor microenvironment (TME). The emergence of anti-angiogenic drugs has provided a new turning point in cancer treatment. An integrated machine learning system was constructed to build the angiogenesis-related gene signatures (ARGS). ARGS was used to assess TME status in BLCA. Pharmacophore construction was employed to construct pharmacophore features of highly cytotoxic drug payload combinations for antibody-drug conjugates (ADCs). In addition, we developed a natural compound using artificial intelligence-driven drug design technology. This compound exhibits anti-angiogenic effects in BLCA and serves as a highly cytotoxic drug payload for ADCs. Multi-dimensional machine learning was used to screen biomarkers for evaluating the post-treatment effects of drug therapy in BLCA. The ARGS consists of 12 angiogenesis-related genes associated with prognostic risk in BLCA. The ARGS divides BLCA patients into high-risk and low-risk groups. Significant TME remodeling was identified in the high-risk BLCA cohort and demonstrated a strong association with tumor angiogenesis. Expression levels of key immune checkpoint markers significantly differed between BLCA risk groups. Saikosaponin D (SSD) shows promising potential as a novel ADC drug for anti-angiogenic treatment in BLCA. Multi-dimensional machine learning results indicate that MYH11 is the most likely biomarker for evaluating the post-treatment effects of SSD therapy. SSD may potentially treat tumors by regulating angiogenesis in BLCA. The detection of MYH11 can be used to assess the therapeutic effectiveness of SSD in BLCA.	bladder
Molecular Characterization of Residual Muscle-Invasive Bladder Cancer Identifies a Scar-Like Transcriptomic Profile with Favorable Prognosis after Neoadjuvant Therapy.	PURPOSE: Many patients have residual disease after neoadjuvant therapy, but their prognosis and need for adjuvant therapy are unclear. This study evaluates patient prognosis based on the molecular profiling of residual disease at cystectomy. EXPERIMENTAL DESIGN: RNA sequencing data from TURBT samples were available from N = 84 ABACUS patients, of whom N = 64 had matched radical cystectomy (RC) samples, including 10 patients with pathologic complete response (ypT0N0). Pre- and post-atezolizumab tumor gene expression data were classified into molecular subtypes using the consensus subtyping model as a benchmark. Unsupervised consensus clustering was performed to categorize RC samples de novo, and each cluster was characterized using gene expression signatures. Two RC cohorts (neoadjuvant chemotherapy, N = 133 and University of Texas Southwestern, N = 94) known to harbor a scar-like biologic cluster were used for training and testing of a single-sample transcriptomic classifier that was validated in two independent (PURE-01, N = 26 ad ABACUS, N = 64) RC cohorts after neoadjuvant immunotherapy. RESULTS: Unsupervised consensus clustering revealed four distinct post-atezolizumab clusters (scar-like, basal, luminal-stromal, and luminal). The scar-like cluster was present in 25% (16/64) of the post-atezolizumab samples and expressed genes associated with wound healing/scarring. A transcriptomic classifier trained to identify a favorable scar-like transcriptomic profile in residual bladder tumors showed robust performance in two validation cohorts, indicating a patient subgroup with favorable prognosis among neoadjuvant chemotherapy-treated, pembrolizumab-treated, and atezolizumab-treated patients with residual bladder cancer. CONCLUSIONS: This study contributes to the framework for defining molecular subtypes at RC. Residual bladder cancer with a scar-like transcriptomic profile may predict favorable patient prognosis after neoadjuvant chemotherapy and immunotherapy, identifying potential candidates for treatment deintensification.	bladder